The Corruption I Saw Working for a Greek Public Hospital
Number one: giving money to a doctor before surgery is a no-no, but after the operation it's just a "thank you present".
All photos are by Orestis Seferoglou and were featured in a VICE Greece article titled 'I Spent Two Nights Driving Around Athens in a Greek Ambulance'. They have nothing to do with the hospital, people or events described in this article.
This article originally appeared on VICE Greece
"I'm assigning you to the blood tests unit, because you seem smart," said the HR Director, calling for one of his staff to get me for my induction. Shortly after, a short-haired redhead wearing black-and-white horn-rimmed glasses and bright red lipstick came to greet me, and led me to the desk from where I would begin my two-year nursing internship.
I must have been around 21 when my university's internship programme gave me the option to work at one of the biggest public hospitals in Athens. I wasn’t too thrilled with the choice, but it was a paid position, which meant I could give up my job as a cafe waitress. And so, on a rainy October morning, I walked through the hospital gates, pushed the heavy wooden door open and got a first whiff of the sterile public healthcare system.
Very soon, I realised a hospital is the worst place to work. It's a chamber of endless pain that smells of death, coffee and antiseptic, where you have to face the best and worst aspects of humanity on a daily basis. It's been about nine years since then, but I'll never forget the morning I saw a woman sitting on the steps that led to the small hospital courtyard. She had a stunned expression on her face and a tissue in her hand. Her young children were frolicking around her, asking for biscuits and juice.
As I passed by, I overheard her bluntly repeating, "Kids, listen to me, dad is dead." I felt she was really trying to impress the concept of death on them, to make them realise they would never again see a man who – just a few hours ago – had been standing among them. I'd never had a more shocking second-hand experience, so I began to walk faster.
As it turned out, every day at the hospital was more of the same. People shouting that they were in pain, people crying in waiting rooms, people carrying bags full of medical documents in endless queues, people talking to relatives on their cellphones. And coffee. An endless stream of coffee.
When I started working there, I was bothered by all the tragic stories, symptoms and diseases surrounding me, to the point that I became a hypochondriac. Every 15 days I made a nurse run a general blood test to make sure I was healthy. In the three months that I worked in that department, I don’t know how many doctors I consulted to reassure myself that I didn’t suffer from some sort of incurable disease.
At the end of those three months I was transferred to another department because I was causing problems for my supervisor. The main issue was that I didn’t stick to the timetable she’d set for patients. For example, she had stuck up a note saying that test results would be declared to patients after 12PM – something I thought was amusing, since we were often given the results earlier and had plenty of time to pass them on before midday. Unlike the overworked but always smiling departmental nurse, our supervisor took her daily morning break between 11 to 12, which meant she was out of the office for a full hour, "for my coffee and a sandwich". I had nothing to do, so every time someone asked for their results I'd just give them. She caught me in the act a couple of times and my tenure in the blood work unit came to an end.
I was transferred to the hospital’s Department of Urology. Four residents worked there, along with three auxiliary nurses and three directors, of which one was purely decorative; he just sat around, waiting to retire. The doctors' office was a very small room on the second floor, furnished with four tiny desks and a few chairs.
My job was to write up the admissions and discharges of patients, seal patient results or retrieve records from the hospital files when needed. I also had to set the surgery schedule and give secretarial support. Overall, it was the perfect job: I had all the time in the world to drink coffee and talk to my friends on Facebook.
Although, at the beginning, I resented it a little because I had to be in a tiny room with ten others, very soon we got used to each other. Doctors are a strange sort; they can be saint-like and evil, paranoid and rational, calm and hysterical, all at the same time.
One day, the manager turned to me and said: "It's almost time for our bonus." He then explained that, three years ago, he'd operated on a patient with prostate cancer. Since then, even though the patient was totally healthy, he’d been getting him to do a specific test every two months at the cost of €200 (£176). This sort of stuff would happen openly in most clinics. It wasn’t the first, nor the last, time I saw a doctor be bribed or shamelessly lie to a patient like that.
The time I spent there was a life lesson, since Greek hospitals are places of more intrigue and drama than every season of House of Cards and Grey's Anatomy squished together. That's where I learned, for example, that giving money to a doctor before surgery is considered "corruption", but after surgery it's a "thank you present". I learned that the money is not given for the procedure – the doctor is obliged to carry that out. The money is supposedly given for the post-operative care, which they are also entitled to. The doctors were obviously aware of all this, but they'd create the illusion that a bribe was necessary for a patient's care. Some would flat out set a price, others were more discrete.
Sometimes I think this whole process – which is endemic in the Greek healthcare system – has caused patients to suffer from something resembling Stockholm Syndrome. The best example of this mentality I can recall is the time a cancer patient insisted on giving me €20 (£18) "to go buy yourself a cup of coffee". What he actually needed me to do was verify his disability certificate, which I couldn't do without a doctor's signature. These certificates were given every Wednesday because that’s when the doctors had time. The patient came to me on a Tuesday.
All I had to do was simply retrieve his file, photocopy the old certificate and pass it on to the responsible doctor who wrote out the diagnosis on the basis of the tests. I told him that, from my end, I’d do what I could and he’d have to wait until the doctor came out of surgery. I awkwardly refused the money by telling him I don’t drink coffee.
Then there were the pharmacy reps. Every morning outside the doctors' offices, along with the patients there would be three or four suited men and women waiting. I don’t know if the symbiotic relationship between doctors and pharmaceutical companies has stopped now, but at least when I worked there the privileges promised by the drug reps were scandalous. Dinners at the Hilton, feasts in tavernas, travel expenses for conferences and all sorts of gifts – from books to watches, every doctor, depending on their seniority, could ask for anything in return for prescribing patients specific drugs. I even got gifts, although I couldn't write prescriptions.
Of course, there were also doctors who were the polar opposite of the above. Those who had a hard time telling patients and their relatives that something was wrong with their health. Those who gave up their personal time for extra shifts in a thankless environment. People who would miss their children's birthdays to deal with an emergency.
They walked around looking pale, with dark circles under their eyes, and when patients gave them gifts they shared them with the nurses and the rest of the staff. When asked, "Doctor, what do I owe you?" they'd reply: "Just take care of yourself," and give free drugs to those without insurance.
Of course doctors should be paid well for their work. But to get to that point, the change must first come from those of us who need them, the patients. We need to shake off the illusion that this is the only way our society can operate, just because we grew up within that system. Then, the rest will have no other options but follow.